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Repair of joint erosions in rheumatoid arthritis: prevalence and patient characteristics in a large inception cohort
  1. Michael P M van der Linden (m.p.m.van_der_linden{at}lumc.nl)
  1. Department of Rheumatology, Leiden University Medical Center, Netherlands
    1. Ramona Boja
    1. Department of Rheumatology, Leiden University Medical Center, Netherlands
      1. Naomi B Klarenbeek
      1. Department of Rheumatology, Leiden University Medical Center, Netherlands
        1. Tom W J Huizinga
        1. Department of Rheumatology, Leiden University Medical Center, Netherlands
          1. Désirée M van der Heijde
          1. Department of Rheumatology, Leiden University Medical Center, Netherlands
            1. Annette H M van der Helm-van Mil
            1. Department of Rheumatology, Leiden University Medical Center, Netherlands

              Abstract

              Background: Joint destruction in rheumatoid arthritis (RA) was until recently seen as an irreversible state. Lately, it was defined that repair of bone erosions occurs; however little is known about its prevalence. This study investigates the frequency of repair and patients characteristics associated with repair in an inception cohort.

              Patients and methods: 250 RA-patients, included in the Leiden Early Arthritis Clinic between 1993-2000 and treated with conventional DMARD-therapy, were studied (mean follow-up 10.1 years). Yearly made radiographs were scored using the Sharp–van der Heijde method, initially aware of the chronology. Patients with a negative change in erosion scores on subsequent radiographs were selected and their series of radiographs were rescored with concealed time sequence by three readers. Repair was defined as agreement of two readers in having a negative change in erosion scores that persisted for at least two years.

              Results: Repair was identified in 32 joints in 18 patients (7.2%). Patients with repair had more frequent autoantibodies (RF,ACPA) and a higher level of joint destruction. In the joints with repair arthritis was absent in the two years preceding repair.

              Conclusions: Repair occurred in 7.2% of the RA-patients, particularly in clinically inactive joints in patients with severe destructive disease.

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